scholarly journals Purine analogues as a risk factor of postoperative complications in abdominal surgery for Crohn’s disease

2012 ◽  
Vol 1 ◽  
pp. 13-19
Author(s):  
Katarzyna Borycka-Kiciak ◽  
Adam Kiciak ◽  
Łukasz Janaszek ◽  
Paweł Jaworski ◽  
Wiesław Tarnowski
Keyword(s):  
Risk Factor ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Purine Analogues

The Impact of Anti-Tumor Necrosis Factor Alpha Therapy on Postoperative Complications in Pediatric Crohn's Disease

2019 ◽  
Vol 30 (01) ◽  
pp. 027-032
Author(s):  
Vojtech Dotlacil ◽  
Jiri Bronsky ◽  
Ondrej Hradsky ◽  
Barbora Frybova ◽  
Stepan Coufal ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Tumor Necrosis Factor ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Tumor Necrosis ◽  
Tnf Α ◽  
Significant Difference ◽  
The Impact ◽  
Necrosis Factor

Abstract Introduction The incidence of Crohn's disease (CD) within the pediatric population is increasing worldwide. Despite a growing number of these patients receiving anti-tumor necrosis factor α therapy (anti-TNF-α), one-third of them still require surgery. There is limited data as to whether anti-TNF-α influences postoperative complications. We evaluated postoperative complications in patients who were or were not exposed to anti-TNF-α therapy in our institutional cohort. Materials and Methods A retrospective review of CD patients who underwent abdominal surgery between September 2013 and September 2018 was performed. The patients were divided into two groups based on whether they were treated with anti-TNF-α within 90 days before surgery. Thirty-day postoperative complications were assessed using Clavien–Dindo classification (D-C); this examination included surgical site infections (SSIs), stoma complications, intra-abdominal septic complications, non-SSIs, bleeding, ileus, readmission rate, and return to the operating room. Mann–Whitney U-test, Fisher's exact test, and multivariate logistic regression analyses were used for statistical analysis. Results Sixty-five patients (41 males) with a median age of 16 years (range: 7–19) at the time of operation were identified. The most common surgery was ileocecal resection in 49 (75%) patients. Forty-three (66.2%) patients were treated with anti-TNF-α preoperatively. Seven patients (11%) experienced postoperative complications. There was no statistically significant difference in postoperative complication in patients who did or did not receive anti-TNF-α before surgery (D-C minor 2.3% vs. 4.6%, p = 1; D-C major 7% vs. 9.1%, p = 1). Conclusion The use of anti-TNF-α in pediatric CD patients within the 90 days prior to their abdominal surgery was not associated with an increased risk of 30-day postoperative complications.

Body mass index: Implications on disease severity and postoperative complications in patients with Crohn’s disease undergoing abdominal surgery

Surgery ◽  
2019 ◽  
Vol 166 (4) ◽  
pp. 703-708 ◽  
Author(s):  
Nicholas P. McKenna ◽  
Elizabeth B. Habermann ◽  
Martin D. Zielinski ◽  
Amy L. Lightner ◽  
Kellie L. Mathis
Keyword(s):  
Body Mass Index ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Disease Severity ◽  
Body Mass

NOD2 gene variant is a risk factor for postoperative complications in patients with Crohn's disease: A genetic association study

Surgery ◽  
2016 ◽  
Vol 160 (1) ◽  
pp. 74-80 ◽  
Author(s):  
Adeline Germain ◽  
Rosa-Maria Guéant ◽  
Mathias Chamaillard ◽  
Patrick B. Allen ◽  
Laurent Bresler ◽  
...  
Keyword(s):  
Risk Factor ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Association Study ◽  
Genetic Association ◽  
Genetic Association Study ◽  
Gene Variant

Anti-TNF and Postoperative Complications in Abdominal Crohn's Disease Surgery

2019 ◽  
Vol 20 (13) ◽  
pp. 1339-1348 ◽  
Author(s):  
Takayuki Yamamoto ◽  
Fabio Vieira Teixeira ◽  
Rogerio Saad-Hossne ◽  
Paulo Gustavo Kotze ◽  
Silvio Danese
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Small Sample Size ◽  
Infectious Complications ◽  
Small Sample ◽  
Increased Risk ◽  
Tnf Α ◽  
Meta Analyses

Background: : Biological therapy with anti-Tumour Necrosis Factor (TNF)-α agents revolutionised the treatment of inflammatory bowel disease over the last decades. However, there may be an increased risk of postoperative complications in Crohn’s disease (CD) patients treated with anti-TNF-α agents prior to abdominal surgery. Objective:: To evaluate the effects of preoperative anti-TNF-α therapy on the incidence of complications after surgery. Methods: : A critical assessment of the results of clinical trial outcomes and meta-analyses on the available data was conducted. Results: : Based on the outcomes of previous reports including meta-analyses, preoperative use of anti- TNF-α agents modestly increased the risk of overall complications and particularly infectious complications after abdominal surgery for CD. Nevertheless, previous studies have several limitations. The majority of them were retrospective research with heterogeneous outcome measures and single centre trials with relatively small sample size. In retrospective studies, the standard protocol for assessing various types of postoperative complications was not used. The most serious limitation of the previous studies was that multiple confounding factors such as malnutrition, use of corticosteroids, and preoperative sepsis were not taken into consideration. Conclusion:: Among patients treated with preoperative anti-TNF-α therapy, the risk of overall complications and infectious complications may slightly increase after abdominal surgery for CD. Nevertheless, the previous reports reviewed in this study suffered from limitations. To rigorously evaluate the risk of anti-TNF-α therapy prior to surgery, large prospective studies with standardised criteria for assessing surgical complications and with proper adjustment for confounding variables are warranted.

scholarly journals Abdominal Surgery in Crohn’s Disease: Risk Factors for Complications

2020 ◽  
pp. 1-7
Author(s):  
Cintia Mayumi Sakurai Kimura ◽  
Arceu Scanavini Neto ◽  
Natalia Sousa Freitas Queiroz ◽  
Natally Horvat ◽  
Mariane Gouvea Monteiro Camargo ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Disease Risk ◽  
Factors Associated ◽  
Urgent Surgery ◽  
Preoperative Optimization ◽  
Increased Risk ◽  
Disease Location

<b><i>Introduction:</i></b> Abdominal surgery in patients with Crohn’s disease (CD) is challenging, especially in the biologic era. The aim of this study was to evaluate factors associated with increased risk for postoperative complications in CD. <b><i>Methods:</i></b> A retrospective study was conducted with consecutive patients who underwent abdominal surgery for CD from January 2012 to January 2018. <b><i>Results:</i></b> Of 103 patients, 32% had postoperative complications. Gender, age, disease location and phenotype, hemoglobin and albumin levels, previous abdominal surgery, and preoperative optimization did not differ between the groups with or without complications. Thirty-five percent of the patients were under anti-TNF therapy, and this medication was not associated with increased risk for postoperative complications. Time since the onset of the disease was significantly higher in patients with complications (12.9 vs. 9.4, <i>p</i> = 0.04). In multivariate analysis, creation of ostomy and urgent surgery were the only variables independently associated with increased risk for complications (OR 3.2, 95% CI 1.12–9.46 and OR 2.94, 95% CI 0.98–9.09, respectively). <b><i>Conclusion:</i></b> Urgent surgery for CD should preferably be performed in specialized centers, and creation of stoma is not necessarily associated with lower rate of postoperative complications but rather less severe complications.

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